Neruo anatomy/function Flashcards
What is Wernicke’s area?
On L side of brain–>deals with understanding written & oral language
If are treating a pt with a CVA/TBI/SCI who has increased tone, hyperflexes, spasms and + clonus. What type of motor impairment do you suspect?
UMN
If a patient has GB or perhipheral nerve injury what motor impairments would you expect?
Low tone, hypo-reflexive, fasiculations (twitch), segmental weakness of strength
According to the Dynamic systems theroy what is the goal driven around?
goal driven around a task (body systems working towards common goal)
List the 10 neruoplasticty principles with examples
- use it or lose it
- use it and improve it
- specificity (need to make tasks specifc to what we want to improve)
- reps matter (need LOTS of reps)
- intensity matters (want high intesntiy-use RPE/HR)
- time matters (closer you are to event=better)
- salienace (relate it to what pt wants to do)
- age matters
- transference (if we work on something it can transfer to other things)
- interference
If a patient is practicing a skill for hours on end all at once what type of practice is being used?
Massed (all at once)
vs distributed=break it up
If a patient wants to learn to walk again and we start with just WB, then weight shifts then steps what type of practice is this?
Part task training
Define blocked and random practice
blocked=repeating same task over and over again
random=different skills randomly (this is better long term)
Your doing a screen on a neruo patient and do sensory testing simultaneously on both UE and they patient reports this as only able to feel on 1 side or just 1 feeling, what is this called?
Extinction phenomenon–>if you individually touch each side pt can feel it but if you do do it together they can’t
During an intial neruo exam a patient is found to be AAOP x 3, what does this indicate?
Pt is oriented to person, place, time BUT not situation
When conducting a light touch exam you test each dermotomal level at once. What is this type of light touch sense testing called?
Dermotomal testing (testing 1 per dermotomal site)
VS cortical=test each limb region 3-5 time (more quick screen)
A post neruo injuired patinet is in flexion synergy for both UE and LE, explain what this means?
Flexion UE=shoulder retreaction &/or elevation, GH flexion, abd, elbow flexion, forearm supination (high 5 position)
UE ext=pro & depression, add + IR, elbow ext, pronation
LE flexion=hip flexion, knee flexion, DF & Inversion (figure 4 like)
A post stroke patient is found to be able to move slightly out of UE flexion synergy. What Brunnstrong stage are they in?
Stage 4=out of synergy
1=flaccid (post injury)
2=synergies, some spastictisity
3=marked spasticity & synergy
4=out of synergy
5=selective control of mvmt
6=can fully move limbs
A PT grades a patients spasticity according to the ASH scale as 1+, what is seen in pt?
slight increase in tone, manifested by catch and little resistance throguh rest of ROM
0=no increase in tone
1=slight increase in tone, catch and relase or min restinace at end ROM
2=more tone through most ROM, but body part moves easily
3=considerable icnrease in tone, passive mvmt issues
4=affected parts are rigid and high tone
Explain ideal plumb limb alignment
Through mastoid process, in front of shoulder, just behidn axis of hip jt, in front of knee, ant to medial malleous
If a patient is pushed from behind to test perturbation strategy what muscles should contract first?
Distal to proximal calves, HS, paraspinals
When testing a patients ability to respond to push from behind perturbations you noticed they contract posterior muscles in response prior to the push, what postural control mechanism is this?
Feed fwd (anticipatory control) before perturbations (proactive)’ provides internal perturbations
VS reactive would be more like pull test (external perturbation)
A patient is tested on the m-CTSIB with eyes open and on foam surface. What level is this?
Level 3=answer
Level 1=eyes open-stable surface
2=Eyes closed on hard surface (vision is taken away)
3=eyes open + foam surface (Vision + vestibular in tact)
4= eyes closed + foam surface (vestibular only one in tact)
Describe the levels of a sensory organization test (SOT)
1=Eyes open on firm surface (testing all 3)
2. Eyes closed on firm surface (testing somato & vestib)
3. Eyes open with sway referenced visual surround (vision not reliable; testing if they rely on visual info to help)
4. Eyes open on sway referenced support surface (normal vision)-testing somatosensory with sway referenced)
5. Eyes closed on sway referenced support surface (testing vestibular)
6. Eyes open on sway referenced support surface and surround (testing vestibular)
**review this
If a patients presents post TBI with ipsilateral impairments what location is the issues?
Cerebellum
A TBI patient shows signs of nystagmus, increased sway and impaired balance, what brain area is impacted?
cerebullum (vestbiulocerebellum)
a post TBI patient has trouble with complex tasks and fine motor skills. They are slow to start tasks and show more UE > LE involvement, what areas is the lesion?
Cerebellar (cerebrocerebellar)-unilateral
List 10 cerebellar deficits if a patient has an injury to that area
ataxia, dyssynergies mvmt, dysarthria (speech formation issues), intention tremor, dysmetria (missing target in reach), hypotonic & reflexive, abnormal gait
You notice a patients nystagmus beats to the R side. Which side could injury be on?
Opposite side, (side of increased neural activity)
So if L stroke/loss–>will see R beating/mvmt of both eyes
